Multidisciplinary quality improvement initiative to standardize reporting of lung cancer screening

Structured reporting of lung cancer screening (LCS) results with low dose computed tomography (LDCT) is necessary for appropriate follow-up and management of lung nodules. We describe processes for standardizing the reporting and tracking of screen-detected lung nodules by increasing documentation of Lung-RADS categorization of lung nodules. Our multidisciplinary team developed a project charter and key driver diagram, revised the radiology reporting template, and provided monthly audit reports to thoracic radiologists. Quarterly from Q1-2015 to Q2-2016, we measured the proportion of screening LDCT reports that included a documented Lung-RADS category. In Q1- and Q2-2015, no LDCT scans contained a Lung-RADS assessment. By the end of Q1-2016, 94% of screening LDCTs contained a Lung-RADS assessment with a recommended follow-up action. We developed systematic processes for lung nodule categorization, documentation, and tracking using Lung-RADS that improved structured reporting at one academic medical center.